Blame & Banishment - Médecins du Monde

Blame and Banishment: The underground HIV epidemic affecting children in Eastern Europe and Central Asia
All over the region, the economic and social stability of the family
is under threat, compromising its pivotal role in supporting,
protecting and nurturing children and youth. At the same time,
efforts to strengthen families have not figured prominently on
state agendas. While countries in Eastern Europe and Central
Asia inherited a strong welfare orientation, declines in revenue
due to economic transformation and slow institutional reform
have meant that governments have not been able to implement
strong social policy interventions to protect or cushion families
as they did in the past. 11 The lion’s share of public expenditure on
social protection goes towards old age pensions, while only much
smaller allocations and subsidies are available to needy families
with children, or those living with HIV.
Alla, five years old, born to HIV-positive parents, has spent all her life
in institutions.
© UNICEF Russia
In Belarus, Bulgaria and The former Yugoslav Republic of Macedonia, in
2005–2006, pensions represented 8.5 per cent of GDP; however, expenditure on
family allowances accounted only for 0.1–1 per cent of GDP. 11
In many countries, targeting efficiency tends to be poor and allocations so insignificant that
they do little to alleviate the financial stress experienced by families. 13 Reports also indicate
that some families of children living with HIV choose to forgo subsidies due to concerns
about confidentiality and discrimination.
Institutions providing care
Overwhelmed, many families in difficulty, especially those supporting the double burden of
HIV/AIDS and financial hardship, turn to state institutions for respite or to have them act as
parental substitutes and raise their children.
The infrastructure of institutional care remains as that of the Soviet era. Infants who are
left in maternities are transferred to baby homes (Dom Ribyonka) where they stay until
the age of three. If they are not adopted during these early years they are transferred to
children’s homes (Dyetski Dom) for the next four years and then onwards to ‘internats’
for 7- to 18-year-olds. This movement through different institutional settings leaves many
children poorly equipped to cope or find jobs once they leave and highly vulnerable to abuse
and exploitation. Young people graduating from these institutions have much higher rates
of alcoholism, drug use, criminal behaviour, unemployment, imprisonment and suicide than
their peers.
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